Cardiothoracic Surgery News

TUESDAY, Nov. 1, 2016 – Even with repeated cleanings, it's virtually impossible to remove all contamination from robotic surgical instruments, a new study suggests. "One of the top priorities for hospitals is to treat patients safely and with minimal risk of infection," said study author Yuhei Saito, an assistant professor at the University of Tokyo Hospital in Japan. "Our results show that surgical instruments could be placing patients at risk due to current cleaning procedures. One way to address this issue is to establish new standards for cleaning surgical instruments, including multi-part robotic tools," Saito said in a news release from the Society for Healthcare Epidemiology of America. Over the course of 21 months, the researchers assessed protein residue on 132 robotic and standard surgical instruments that were cleaned according to manufacturers' instructions. The cleanings ... Read more

FRIDAY, Oct. 28, 2016 – The Amplatzer PFO Occluder device has been approved by the U.S. Food and Drug Administration to prevent another stroke among people who had at least one prior stroke involving a PFO (patent foramen avale). A PFO is a small hole in the heart that could allow passage of a blood clot. Up to 30 percent of Americans have a PFO, the FDA explained in a news release. The condition typically causes no health issues and doesn't require treatment. However, in a small number of cases, the PFO provides "a path for a blood clot to travel to the brain where it [blocks] a blood vessel resulting in a stroke," the agency added. The new device is inserted via a catheter in a leg vein and is advanced to the heart. It was FDA approved nearly a decade ago, but its manufacturer withdrew the application for approval after the agency told the manufacturer that more than 4,000 people ... Read more

THURSDAY, Oct. 20, 2016 – Taking medications as prescribed improves outcomes for heart procedure patients, a new study finds. Researchers looked at 973 heart bypass patients and 2,255 patients who underwent angioplasty and stenting to reopen clogged heart arteries. Heart bypass surgery is when surgeons take a piece of blood vessel from somewhere else in the body to bypass a blocked portion of the heart's artery. Angioplasty is performed using a thin catheter that's threaded through the blood vessels to the heart. A balloon on the end of the catheter is inflated to open the narrowed blood vessel. Sometimes a stent (a mesh or wire tube) will be left in the blood vessel to keep it open. Prescribed medications in the study included cholesterol-lowering statins, blood thinners and beta blockers. Follow-up information was collected 12 to 18 months after the heart procedures. Overall, ... Read more

THURSDAY, Oct. 20, 2016 – A new study challenges the belief that women are more likely than men to develop kidney damage after heart surgery. Researchers reviewed 64 studies that included more than 1 million patients to see the actual risk of acute kidney injury (AKI) after heart surgery. AKI is a sudden decrease in kidney function. This condition can occur when kidneys are deprived of normal blood flow during major surgery. The studies covered a period of more than 25 years. Previous research has shown that women are more likely than men to develop kidney damage after heart surgery, yet the opposite is true after general surgery. The new study found that women, in general, were more likely than men to develop kidney damage after heart surgery. But, this wasn't the case when patient characteristics and other factors were taken into account. For example, women having heart surgery were ... Read more

THURSDAY, Oct. 13, 2016 – Special devices used during open heart surgery may have been contaminated with bacteria that puts patients at risk for life-threatening infections, U.S. health officials warned Thursday. Some LivaNova PLC (formerly Sorin Group Deutschland GmbH) Stockert 3T heater-cooler devices, which are used during many open heart surgeries, might have been contaminated with Mycobacterium chimaera bacteria during manufacturing, the officials said. People who have had open heart surgery should seek medical care if they have infection-related symptoms, such as night sweats, muscle aches, weight loss, fatigue or unexplained fever, the U.S. Centers for Disease Control and Prevention said in a news release. The agency also said that hospitals and doctors should identify and inform patients who might have been put at risk. "It's important for clinicians and their patients to be ... Read more

THURSDAY, Oct. 6, 2016 – Screening older surgery patients for frailty could improve their outcomes and chances for survival, researchers say. But frailty often goes unrecognized in these patients, according to a study published online Oct. 6 in The Annals of Thoracic Surgery. "Patients with frail health have less ability to overcome stressors such as illness, falls and injury, and have a higher risk of adverse effects from medications, procedures and surgery," study co-author Dr. Angela Beckert said in a journal news release. Beckert is an assistant professor in the division of geriatrics and gerontology at the Medical College of Wisconsin, in Milwaukee. "If a patient is more robust, with better physical performance and vigor – in other words, less frail – then I believe surgical outcomes would be better," she added. Beckert's team screened 125 patients for signs of frailty; their ... Read more

TUESDAY, Aug. 30, 2016 – Patients who suffer a heart attack live longer now than they did before, and invasive procedures such as angioplasty, stents and bypass get a lot of the credit, a new study suggests. While medicines and healthy lifestyle remain important, "it was the increased and more widespread use of this invasive coronary strategy that explain the changes/improvements in survival after heart attack" between 2003 and 2013, said study author Dr. Chris P. Gale. He is associate professor and consultant cardiologist at the University of Leeds in England. Gale's team noted there's been a steady decline in the rate at which people die in the months after a heart attack. But what's driving that good news? To find out, Gale worked with Leeds co-author Dr. Marlous Hall and others to track information from a 2003-2013 database on nearly 400,000 heart attack patients living in England ... Read more

MONDAY, Aug. 29, 2016 – People who have an implanted cardiac defibrillator (ICD) to control an irregular heartbeat appear to have more car accidents than similarly aged people without such devices, a new Danish study finds. Overall, Danish drivers with ICDs were 51 percent more likely to be involved in a traffic accident over the two-and-a-half years of the study. But the findings aren't necessarily a reason to tighten restrictions on these drivers, since the absolute risk of any one ICD-using driver being involved in an accident remained very low – around 1 percent a year. The issue is a tough one, said study lead author Dr. Jenny Bjerre, a physician at Herlev and Gentofte University Hospital in Copenhagen. "On the one side, as physicians we need to take public road safety into consideration when we assess if these patients are medically fit to drive," she said. "But we also have to ... Read more

FRIDAY, Aug. 12, 2016 – New surgery guidelines for certain breast cancer patients could reduce both unnecessary surgeries and recurrence rates, three U.S. cancer groups say. The guideline is for treatment of women with ductal carcinoma in situ (DCIS) who undergo breast-conserving surgery with whole breast radiation. DCIS is an early stage cancer. "The use of a 2-millimeter margin as the standard for an adequate margin in DCIS treated with whole breast radiation therapy is associated with low rates of recurrence of cancer in the breast and has the potential to decrease re-excision rates, improve cosmetic outcome and decrease health care costs," according to the guideline from the Society of Surgical Oncology, the American Society for Radiation Oncology and the American Society of Clinical Oncology. "Margins more widely clear than 2 millimeters do not further reduce the rates of ... Read more

FRIDAY, July 29, 2016 – Only certain women with cancer in one breast should have their healthy breast removed in an attempt to prevent cancer, a leading group of breast surgeons maintains. The new position statement from the American Society of Breast Surgeons comes at a time when more breast cancer patients are asking doctors to remove the unaffected breast – a procedure known as contralateral prophylactic mastectomy. "Contralateral prophylactic mastectomy is a growing trend that has generated significant discussion among physicians, patients, breast cancer advocates and media," said position statement lead author Dr. Judy Boughey. She is professor of surgery at Mayo Clinic in Rochester, Minn. However, "it is important for patients to understand it does not improve their cancer outcome and for them to understand the pros, cons and alternatives to [contralateral prophylactic ... Read more

THURSDAY, June 2, 2016 – Millions of refugees aren't getting the surgery they need, researchers report. "When planning to take care of refugees, much thought is put into how to house and feed and clothe people who are far from home for circumstances often beyond their control. But surgery is a basic need and nobody talks about this," said Dr. Adam Kushner, leader of a new study conducted at the Johns Hopkins Bloomberg School of Public Health in Baltimore. An analysis of data from the United Nations and other sources estimates that the roughly 60 million refugees worldwide may need at least 2.8 million surgeries a year. But their circumstances make it difficult to receive that type of medical care, the researchers added. The types of surgeries required range from broken bones and hernia repair to cesarean sections, cleft lips, gallbladder removal and burn care, the study found. The ... Read more

WEDNESDAY, June 1, 2016 – Severely obese people may have a higher risk of certain complications after heart bypass surgery than normal-weight patients, a new study suggests. The researchers found that severe obesity was linked to much higher odds of developing an infection soon after heart bypass surgery. And severely obese patients were also more likely to have longer hospital stays than normal-weight patients. For the study, the investigators reviewed data from more than 7,500 Canadians who had coronary artery bypass surgery between 2003 and 2014. This surgery redirects blood flow to the heart around clogged arteries. People with a body mass index (BMI) of 40 or more were considered severely obese. BMI is a rough estimate of a person's body fat based on height and weight. A BMI between 35 and 39.9 is considered severe obesity, while 30 to 34.9 is obesity. A normal BMI is 18.5 to ... Read more

WEDNESDAY, May 11, 2016 – Assessing the prognosis of a loved one who's scheduled for heart surgery may be as easy as watching them walk, a new study suggests. Patients who aren't able to walk a short distance at a comfortable pace before heart surgery are at greater risk for death following heart procedures, says a team of Canadian researchers. One U.S. doctor wasn't surprised by the finding. "We knew people with a slower gait speed would have a harder time recovering, and it's helpful that these initial impressions are now supported with data," said Dr. Scott Schubach, chair of cardiovascular surgery at Winthrop-University Hospital, in Mineola, N.Y. For the study, researchers led by Dr. Jonathan Afilalo of McGill University in Montreal assessed heart patients' gait speed – the ability to walk about 16 feet in a reasonable amount of time. Gait speed, the researchers explained, reveals ... Read more

WEDNESDAY, May 4, 2016 – Taking cholesterol-lowering statins right before heart surgery, once touted as a way to prevent common postoperative complications, has no benefit and may even cause harm, a new study suggests. In that setting, Crestor (rosuvastatin) did not prevent either the abnormal heart rhythm known as atrial fibrillation or heart damage, and it was linked to a slightly increased risk of kidney damage, researchers said. "There are many valid reasons why one may want to take statins, but prevention of postoperative complications in cardiac surgery is not one of them," said lead researcher Dr. Barbara Casadei. She is a professor of cardiovascular medicine at the University of Oxford in England. "Our study is consistent with the idea that well-established beneficial effects of statin therapy, such as the reduction in heart attacks and strokes, are only achieved by long-term ... Read more

WEDNESDAY, May 4, 2016 – Many heart bypass patients are skipping medications meant to maintain smooth blood flow in their repaired veins, a new study finds. "It is important for patients to understand that bypass surgery is a second chance, not a cure for their disease," Dr. Michael Savage, a professor of cardiology at Thomas Jefferson University in Philadelphia, said in a university news release. Research has shown that taking statins and aspirin helps keep vein grafts used in bypass surgery open over the long term, and the American College of Cardiology and the American Heart Association recommend taking both medications unless they are unsafe for a patient. But among the more than 400 patients in the study, only 52 percent were taking the recommended combination of statins and aspirin. Sixty-seven percent were taking just a statin and 75 percent were using aspirin only. Those who ... Read more